Jan 30, 2010

What Do I Want To Be When I Grow Up?

One of the great things about medical school is it allows you to put off the question "what do I want to be when I grow up?" Sure, you decide to become a doctor and go to medical school. But the real decision- what kind of doctor you're going to be- is put off for another four years post college graduation. While your peers are stuck in a working world trying to find their niche, you are protected in the safety catchall of "I'm in medical school."

I'm supposed to decide on a specialty soon. There is this TV show, Scrubs, that I love because it portrays the experiences of a couple young physicians. It's goofy, but really taps in to some experiences that must be essentially universal for all young doctors. One episode (that I saw while in my first year of medical school) shows the student sitting on his stuffed unicorn, asking it what his specialty should be. At the time I thought, well that's stupid. They must have put that in there just to make the audience laugh. Now that the time is near for me to choose a specialty, that actually seems like a reasonable solution. I have no better ideas for how to make the decision.

So much of the perceptions of the clinical rotations is subjective based on the experiences that the student had during that time. Do I dislike family medicine because the patient population that I worked with was noncompliant, the clinic was four degrees too warm and smelled like a bologna sandwich, and the attending didn't let me talk or touch? Or is it because I really don't like being only the sounding board for problems; for having to redirect anything too serious into the direction of a specialist? Do I love ob because I had an attending that let me do deliveries, assist in surgery, and do patient exams on my own? Will I still love deliveries when they are in the middle of the night and I've been doing this for thirty years? Is it just the novelty and excitement of the experience that I love, or is it really that I love the experience?

Someone told me once to pick the specialty that you actually want to read the journals that they send you. I think that advice actually has a lot of merit. Once I got into medical school, I seem to have automatically ended up on the mailing list of every professional organization out there. I now get more junk mail from professional medical groups than I do from the grocery store, drugstore and LL Bean combined. From the mail that lands on my coffee table, the journals for cardiology, surgery, neurology, and pediatrics get tossed in the recycle bin immediately. I'll peruse the journals of osteopathic research, oncology, and family practice, and then recycle those. The journal of obstetrics and gynecology gets read and kept for another look.

Despite these inclinations to a particular practice, its still hard to choose. It's unsettling to commit to a lifestyle of being on call. Specialties like dermatology, ophthalmology, and anesthesia offer a comfortable, rested lifestyle (which is very appealing in itself) but possess less inherent interest for me than obstetrics.

So, I'm kind of left where I started. Do I choose a practice that I declare the hours and workload, and am left with medicine that I like but don't care deeply about? Or do I match with a residency that trains me for a lifestyle of long hours but rewarding work? I'm not sure. But I'll have to figure it out pretty soon.